<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <!-- <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('退款金额')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-refundprice" data-rule="required"  name="row[refundprice]" class="form-control" type="text" value="{$data.refundprice|htmlentities}">
        </div>
    </div> -->
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('退款原因')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-apply" name="row[apply]" class="form-control" type="text" value="{$data.apply|htmlentities}">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('退款图片')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-apply_images"  class="form-control" size="50" name="row[apply_images]" type="text" value="">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-apply_images" class="btn btn-danger faupload"
                                  data-input-id="c-apply_images"
                                  data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp"
                                  data-multiple="true" data-preview-id="p-apply_images"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-apply_images" class="btn btn-primary fachoose"
                                  data-input-id="c-apply_images" data-mimetype="image/*" data-multiple="true"><i
                            class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-apply_images"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-apply_images"></ul>
        </div>
    </div>
    
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed  disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>




